Treating patients with movement disorders using MRI-guided focused ultrasound: recent developments and challenges

MRI-guided focused ultrasound (MRgFUS) is being considered in the treatment of movement disorders like essential tremor and Parkinson's disease and has shown promising preliminary results both in terms of effectiveness and safety. However, several technical challenges have come to light that must be addressed. This review examines several studies using MRgFUS to treat essential tremor and Parkinson's disease and discusses the following challenges: adequate energy delivery with brachycephalic and dense skulls, adverse events related to procedural time, the need to further understand the role of high-intensity focused ultrasound in brain mapping, and the need for multiple sonications at lesional temperatures for permanent tremor capture. Preliminary experiences reported with this technology have been promising, and the challenges discussed here can be addressed with additional data and experience. In the future, MRgFUS is likely to play an important role in the treatment of movement disorders.